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A Review of Victorian Health Care Deficits

   

Added on  2020-03-23

28 Pages8071 Words253 Views
Running head: CHANGE MANAGEMENTChange ManagementName of the StudentName of the UniversityAuthor’s Note

1CHANGE MANAGEMENT1 Given this review will affect all Victorian hospital and health services:What are the major health care deficiencies addressed by the review?Which of the National Safety and Quality Health Service Standards (2012) do thesedeficiencies relate to?IntroductionDuckett report 2016 was commissioned in the response to a review of the role ofDepartment of Health and Human Service in detecting and managing critical safety risks andclinical governance in the hospital system. It was due to the occurrence of a cluster of perinataldeaths at Djerriwarrh Health Service in between 2013 to 2014. Duckett in his report clarifies themisconception held by the Victorian population about the high quality healthcare across thesystem. He highlighted the significant deficiencies in Victorian healthcare system and health caresystem’s defences against the avoidable patient injury. Duckett’s work is a review of the hospitalacquired diagnoses in the Victorian healthcare system that concludes the existence ofcomplications in the hospital. The report states that around 300,000 patients suffer acomplication in the Victorian hospital while receiving healthcare every year and at least 70,000of them were potentially preventable. He also identifies a lack in monitoring process of theoutcome data and it circulation in the hospitals to efficiently deal with similar situations thatmight occur in the future. Duckett suggested a series of modification in the Victorian HealthService in achieving the high level of clinical governance on safety and quality, monitor andcirculate the outcome data and increase the efficiency of response when things go wrong. Thisessay will primarily identify the healthcare deficiencies mentioned by Duckett and his team in

2CHANGE MANAGEMENTthe review and relate them with the standards of National Safety and Quality Health Service2012. Major Health care Deficiencies Identified in the Duckett’s ReviewDuckett and his team have identified several issues that need attention to eradicate thehealth care deficiencies prevailing among the Victorian hospitals. The review addresses some ofthe major deficiencies that are discussed in the following.Isolation in GovernanceMany of the hospitals in Victoria achieved success in innovation, accountabilities to localcommunities and even reflect exceptional leadership. However, these successes are limited to theparticular hospital. Duckett’s (2016) report identifies the principle of devolution and localautonomy among for justifying the inadequacy and inefficiency of the healthcare system indisseminating the innovations achieved by individual hospitals. Implementation of strategies,incentives and cultural development are the keys to achieve the standard quality and safety asidentified by Bismark, Walter and Studdert in their work in 2013. Duckett’s report (2016) findssignificant gap in the legislative requirements for big and small and the private hospitals. Thiscontributes to the variation in adequate skills in both financial and legal sector (Bismark &Studdert, 2014). Lack of proper justification leads the community to formulate the idea that thesedeficiencies are the medical issues that are resulting into the low quality of health service andsafety. Implementation of strategies and specifying the roles and responsibilities of the board canhelp the hospitals increasing the quality.Complication of Health Care

3CHANGE MANAGEMENTAccording to Duckett (2016), the complications that exist in the Victorian hospitals are afrequent case. The total number of the patients suffering from a complication in Victorianhospitals is above 300,000 out of which, around 70,000 were preventable. Moreover, Duckettscalculated a total number of 250 surgical deaths in Victorian Hospitals. The report made fromAustralian research identifies that one out of ten patients undergo a complication of health careduring their treatment that can easily be avoided. The maximum numbers of the complicationsonly have minor impact on the patients; however, some of the affected patients faces permanentdisability and death. On the other end, these complications have devastating effect for thepatients their families and healthcare system as it significantly increases the cost of the careacross the system. Furthermore, these complications arise within the complex, high-pressureenvironments where mistakes are likely to occur. The hospitals need process of minimising therisk and consequences of human error. These complications results into failure of the system.The hospitals definitely need efficient management support that is support from the departmentto address the health care deficiencies. It might also facilitate the hospitals in taking swift andappropriate decisions during the strenuous situation by releasing the steam. The implementationof efficient manager can also result in strengthening the safety and quality of their care by usingtheir vantage point and economies of scale to coordinate, facilitate and encourage improvementin efforts across the system. Lack of Transparency in Health care SystemLee et al. (2015) pointed out the importance of transparency in the health care system isessential for maintaining high quality care. The patients and his family must know all the detailsrelated to the patient’s care and the charges (Christensen, Floyd & Maffett, 2016). The lack oftransparency and accountability in the health care deliverance is present in the system (Lee et al.,

4CHANGE MANAGEMENT2015). The various events of death at Djerriwarrh Health Services highlighted the deficiency.Duckett (2016) argued for the transparency in the healthcare where the hospital is accountablefor investigating the cases, and engage in an open disclosure with the effected families. Thehealth care lack transparency as the process of treatment, chances and other important factors arenot properly communicated with the patients. Hence, the patients and their family and friendsfind it difficult to make decision best suited for their situation. This reduces the efficiency, safetyand the overall quality of the process of health care in the Victorian hospitals (Hor et al., 2013;Ledema et al., 2012). The family members and friends of the patients should be informed aboutthe identified risk of the procedure to take proper decision where both the public and privatehospitals fail. Not only this Victorian public has no information about the safety standard or therecord of the hospital and even if there is any information available it gives public falseimpression about safety. Flow of information and Data Sharing IssuesThe department should take responsibility for monitoring the safety and quality inVictoria’s hospital sector. The essential data are rarely collected or used or made available in anaccessible form that limits the clinicians’ ability to use information to identify opportunities forimprovement and strengthen safety and Quality of the care. Sometimes, routine is maintained fordata collection on preventable surgical and perinatal deaths; however, it is rarely accessed by thehospital in future cases. Anderson and Kodate (2015) find importance of information in thecontinuously improving system and related it to the reporting system which can play the role of auseful resource for providing the critical data required for continuous improvement and riskmanagement. Their view was supported by Van Spall, Kassam and Tollefson (2015). The reportfrom the Department of Health (2017) also states about the limitations in monitoring and flow of

5CHANGE MANAGEMENTdata in Victorian health sectors. It evidences that only one percent of the total of 300,000 adversecases are properly reported which can be used to support Duckett’s findings. The administrativedepartment fails to follow a standard for monitoring and data collection on the patient outcomes.Moreover, the administrative department does not have any idea of the number of complaintsagainst individual practitioners. This disrupted information flow is a result of fragmentedcustodianship of data across the system combined with underuse of existing data. The data onclinical governance and safety issue is not shared by the department to the AHPRA on a routinebasis. It results into failure of AHPRA in risk assessment. It means that the information on thecases related to unsafe and low quality service is not circulated to AHPRA. It reflects significantconsequences that can mean that a lack of broader context about a health service can hinderinvestigation of individual practitioners, which otherwise be warranted. No amount ofinvestigation and intervention can speed up the process until the data is flows between thehospitals and AHPRA. The issue could only be eradicate if is flows from both sides. Moreover,the report presents the need of increased data collection and analysis and calculation of combinedprone score using the pooled data from AHPRA and HCEs. Cultural IssueThe workplace culture is one of the essential factors in the health care sector forproviding quality care and maintaining safety of the care (Holland, 2017; Jeffreys, 2015). Thereview evidenced a number of unsafe health care practices that were deliberately continued overyears. Duckett evidenced that a number of staff complaints were ignored, discouraged or evendismissed. The internal management did not detect the problem and failed to address the issues.This is the result of a weaker culture of reporting the cases of unsafe and low quality service thattook place in the Victorian hospitals.

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